Getting pre-pregnancy counseling means taking the first step to have a healthy pregnancy. In addition to the smear test, TORCH group infections, HIV and Hepatitis tests, the tests performed before pregnancy include blood sugar, HbA1c, which shows the 3-month blood sugar level, blood count, thyroid, kidney and liver function tests and urinalysis. In this case, when we receive the results, we screen the expectant mother's general health condition, whether she is a carrier or chronic diseases, and the risk of cervical cancer. Vitamin and mineral deficiencies that are previously known or suspected due to nutrition style are also screened before pregnancy and resolved with the necessary treatments, thus taking the first step towards pregnancy. It is of great importance in preventing Spina Bifida disease and is recommended by WHO. It should be continued until at least the 12th week after pregnancy.
PREGNANCY FOLLOW-UP
The aim of pregnancy follow-up is to determine the risks step by step according to the week, as before pregnancy, and to take precautions by performing the necessary screening tests. . Some of the screening tests show the health status of the mother, and some show the health status of both the mother and the baby. Some tests aim to detect genetic or structural abnormalities in the baby.
Regular weight and blood pressure monitoring is very important throughout pregnancy. The situation becomes even more important in those diagnosed with Hypertension before pregnancy. Towards the end of pregnancy, pregnancy-related high blood pressure may occur, as well as rapid weight gain due to increased edema. During pregnancy, the target is to gain an average of 10-18 kg, although it may be less or more than the previous weight. It is also considered normal to gain less weight or no weight gain in the first 3 months due to nausea, vomiting, and smell sensitivity. It is ideal to gain 1-2 kg per month on average.
SCREENING TESTS DURING PREGNANCY
In addition to screening tests for infection and chronic diseases, there are also screening tests that need to be performed at certain weeks during pregnancy.
10. With the NIPT test, which can be performed from the first week until the end of pregnancy, baby DNA is obtained from the mother's blood with a 99% accuracy rate and it is screened for Down syndrome and similar genetic diseases. It is mentioned.
11-14. Down syndrome and 2 other similar diseases are screened with an accuracy rate of 80% between weeks, and measurements must be taken with a detailed ultrasonography along with this test.
1. It is recommended that trimester detailed ultrasonography be performed routinely in all pregnancies, regardless of this test. Apart from genetic diseases, risks such as structural anomalies, the mother's pregnancy blood pressure, and the baby's developmental delay in the womb can also be detected during ultrasonography.
16-18. If other tests have not been performed between weeks 3 and 2, the quadruple test has been performed, and if they have been performed, the risk of spina bifida is determined by the AFP Mom value in the mother's blood.
20-22. Detailed heart and other internal organ anomalies are investigated with detailed ultrasonography around the 2nd trimester weeks, and the risks of high blood pressure and developmental delay are evaluated.
24. Gestational diabetes screening is performed with OGTT test at week 75 and thereafter, and complete blood count is repeated for anemia.
28. The risk of premature birth is investigated by checking the cervical length around the week.
VITAMIN USE DURING PREGNANCY
Since pregnancy is not a disease, the use of many medications does not have a positive contribution to pregnancy. However, if there are some deficiencies in the expectant mother's body, replacing them will positively affect the health of the mother and baby. Iron deficiency closely affects the health of both mother and baby, and related anemia can even lead to postpartum bleeding. It is a vitamin that is recommended to be used in the first 3 months regardless of folic acid deficiency. It is a water-soluble vitamin and excess is excreted in the urine before it accumulates in the body. In areas of iodine deficiency, iodine supplementation is made by looking at thyroid tests, and iron supplementation is started after the 3rd month as the mother's need increases. Expectant mothers who have never consumed fish or who do not have access to fish are recommended to supplement omega 3 with natural sources such as walnuts or as medicine. Apart from this, calcium supplements are also recommended for those who cannot consume enough milk and dairy products. Almonds are also a herbal source containing plenty of calcium. Vitamin D deficiency is quite common in our society, especially in the winter months. Vitamin D supplementation (10 drops per day) is also recommended.
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